NPI | 1134178825 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: NM 3504) |
Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT 21066) |
Enumeration Date | 2006-05-09 |
Last Update Date | 2022-07-21 |